| NPI | 1598111221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AL 1569) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AL C2633A) |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2016-05-12 |